The poor often rely on expensive emergency care, and the cost is passed on to all consumers. So why is the GOP against expanding Medicaid to help cover those costs?AP File Photo

A
few years ago, I interviewed the chief executive officer of a small
mid-Michigan hospital about the future of health care. I also talked to the
hospital's chief financial officer.

When I asked both of them, independently,
what course the nation should take in health care, they answered as if in one
voice: Make it universal. This was before Barack Obama was elected president,
so it was before the highly vilified Obamacare.

Owing
to an aging population, health care costs will continue to rise for a generation
and those costs will have to be covered increasingly by the federal government
as more people transition off private health insurance and onto Medicare. With
end-of-life care generally the most expensive and with fewer people as a
percentage of the population paying into health care in general, the ultimate
result will be health care rationing imposed on us as a matter of the
marketplace. Better to have young, healthy people invest in a universal pool to
sustain it for when they get older and require its services.

Pressure
from an aging populace was one driver. Another was health care costs incurred
by hospitals while treating the uninsured. These are the people who get no
preventative care and have to go to a hospital emergency room when they get
sick.

Instead of treating heart disease with a relatively inexpensive regimen
of aspirin, Lipitor and advice on diet and exercise, the uninsured just call
911 when they have chest pains. Hospitals are legally obligated to treat these
people as a condition of federal funding, and the uninsured tend to be poor, which
means they tend to not be able to pay their bill. Cheap preventative care turns
into expensive emergency care, and the hospital balances its ledger by raising
prices for everyone else.

This
brings us to expansion of Medicaid, something which the business community
wants to see but which the state Legislature – allegedly a pro-business
Legislature – is hesitant to do. They're still fighting it because, you know,
Obamacare. They're cloaking it under an argument that the feds won't make good
on a promise to fund it.

There
is something to that argument. The federal government did that just last decade
during the Bush years, and it did little to address health care costs and lots
to make pharmaceutical companies more profitable. The state, too, has a habit
of breaking revenue sharing promises and pledges to pay for fire protection to
cover state-owned properties, so they know firsthand of what they speak.

A
lot of the opposition, however, is the sort of anti-Obamacare foot stomping
that prompted the state to forego a state-managed health care exchange for a
federal cookie cutter one. It only makes sense when viewed entirely through a
political prism. They are opposed to it because it came from a Democratic
president. They are opposed to it, also because the Republican Party no longer
appeals to moderates but its fringe.

That fringe, which ironically caters to
many people already on Medicare, would mount a primary challenge against anyone
who puts the common good before partisan posturing. It's the "Party of No" at
every level.

From
a practical standpoint, however, it's terrible policy. That's why business
groups were earlier this week lobbying the Legislature to expand Medicaid.
Expanded Medicaid means that some of those people who use hospitals as
caregiver of last resort get to see a doctor for preventative care. Even if
they wind up sick, a larger portion of their bill will at least be covered. Even
where Medicaid reimbursements are below the cost of treatment, care providers
at least can be assured that part of the bill will be paid.

That
means reduced costs for private insurance, which means cutting employee-related
costs for employers. It also means care givers better able to handle rising
health care costs because the pool of insured patients grows. It's a win-win
for everyone, including a Democratic president, and that last bit is a very
unappetizing piece of gristle to choke down for the party that runs the
Legislature.

Eric Baerren is a weekly columnist for The Morning Sun of
Mount Pleasant and runs the website Michigan Liberal. He can be reached atebaerren@gmail.com.